Provider Demographics
NPI:1952367302
Name:WON, OK HEE (MD)
Entity Type:Individual
Prefix:
First Name:OK HEE
Middle Name:
Last Name:WON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 822227
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19182-2227
Mailing Address - Country:US
Mailing Address - Phone:570-558-4560
Mailing Address - Fax:570-558-4564
Practice Address - Street 1:781 KEYSTONE INDUSTRIAL PARK
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512
Practice Address - Country:US
Practice Address - Phone:570-558-4560
Practice Address - Fax:570-558-4564
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020059E207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
165196OtherBS
PA0009736970003Medicaid
220005848OtherRR MC
PA0009736970003Medicaid
220005848OtherRR MC